Senior Credentialing Director

4 days ago

Columbia, Maryland, United States Medstar Full time
About MedStar Health

MedStar Health is a leading healthcare organization dedicated to delivering high-quality patient care. We're seeking a highly skilled Senior Credentialing Director to join our team.

Job Summary

The Senior Credentialing Director will oversee the day-to-day management of credentialing processes for medical providers within MedStar Health. This role ensures compliance with regulatory requirements, accreditation standards, and organizational policies. The ideal candidate will have strong leadership and team management skills, with the ability to motivate and develop staff.

Key Responsibilities
  • Supervise and lead a team of credentialing specialists, providing guidance, training, and professional development opportunities to enhance their skills and performance.
  • Monitor team performance, set goals, and ensure accountability for achieving department objectives.
  • Oversee the processing of initial or reappointment credentialing applications, ensuring that all required documentation is collected, verified, and reviewed according to established procedures.
  • Ensure compliance with all relevant regulatory and accreditation standards, including those set by The Joint Commission, NCQA, CMS, and state-specific requirements.
  • Coordinate with medical staff offices, department heads, and other stakeholders to facilitate the credentialing and privileging process.
  • Identify opportunities to streamline credentialing workflows and enhance operational efficiency, including the use of technology and automation.
  • Implement and maintain quality assurance measures to ensure accuracy and completeness of credentialing files.
  • Participate in continuous improvement initiatives to reduce turnaround times and improve customer satisfaction.
  • Ensure that all credentialing activities comply with internal policies and external regulations, mitigating risks associated with non-compliance; conduct regular audits of credentialing files and processes to identify areas for improvement and implement corrective actions as needed.
  • Maintain up-to-date knowledge of regulatory changes and industry best practices to ensure ongoing compliance.
  • Serve as a key point of contact for internal stakeholders, including medical staff leadership, department heads, and other relevant parties.
  • Collaborate with the Senior Director and other managers within the Central Verification Office to ensure consistency and alignment of credentialing processes across the system.
  • Respond to inquiries and resolve issues related to the credentialing process in a timely and professional manner.
  • Utilize credentialing software and databases to manage provider information and track the status of applications.
  • Generate regular reports on credentialing activities, including metrics related to processing times, compliance, and team performance; provide insights and recommendations to the Senior Director based on data analysis and trends.
Requirements
  • Bachelor's degree in Healthcare Administration, Business Administration, or a related field.
  • 1-2 years of previous supervisory or management experience within healthcare credentialing or medical staff services.
  • 5-7 years of experience in a Central Verification Office (CVO) or similar centralized credentialing and verification environment.
  • Certified Provider Credentialing Specialist (CPCS) and Certified Medical Professional Services Management (CPMSM) certifications preferred.
Salary

The estimated salary for this position is $70,428 - $131,310, depending on experience and qualifications.

About the Company

MedStar Health is a leading healthcare organization dedicated to delivering high-quality patient care. We're committed to providing a supportive and inclusive work environment that fosters professional growth and development.

Why Join MedStar Health

At MedStar Health, we're passionate about delivering exceptional patient care and making a positive impact in our community. If you share our commitment to excellence and are looking for a challenging and rewarding career opportunity, we encourage you to apply.

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